Appt with Dr. Hollman Today

Just as every other doctor and therapist has told us, Dr. Hollman said that she would love to tell us a definitive diagnosis....but, she can't at Lydia's age. She is definitely concerned with her delays (lack of eye contact and tracking; lack of responsive smiles; not picking up her head in the prone position; feeding issues), but we can only wait to see how Lydia develops to determine if there is a specific cause and what her prognosis will be. She said, as a neurologist, she tells patients that it is good news when there isn't a diagnosis (from an MRI, etc.) because usually if there is a diagnosis- it is really bad. I asked what type of possible cause she would suspect, and she said some type of metabolic disorder...which is what we are testing for with Dr. Superneau. She was pleased with Elise's progress and happy that she is getting so much therapy. She pointed out that we also don't have a diagnosis for Elise. She jokingly said, "I'm sorry we've been so much help to you." I asked if she thought the two conditions were related, and she wasn't convinced of that...since the symptoms are somewhat different. She too said that she didn't consider Lydia's muscle tone terribly low. I asked about autism since I've seen so much about it in the news lately...I thought it may be a possibility for Lydia. She said that it is possible down the road, but it does not typically present itself in this way. She said that most kids with autism develop normally for the first year of life. There are usually no signs of anything wrong until about 2 years of age. Interestingly, though, she said that there is truly an epidemic of autism right now...when she started practicing 24 years ago, about 1 in 200 of her patients were autistic...now about 25% of her patients have autism. That was an interesting fact to me. Dr. Hollman wants Lydia to see an optomologist to have her eyes checked to see if that is the reason she is not making eye contact...something some friends had suggested might be the issue with that. We'll find out. She also was happy that I had started the paperwork for Early Steps to begin getting Lydia some therapy. She also said that PT with Susan Ducote is a good idea...I told her that if I was going to get a physical therapist...I wouldn't see anyone else...she is without-a-doubt -- the best in the field, in my opinion. She suggested that we do OT through Early Steps and use insurance for PT with Susan. Dr. Hollman wants to see Lydia again in 2 months, and she wants to see Elise again in 6 months. I told her how all of Elise's speech therapists have said that she will probably need therapy well into elementary school, and then once she begins speaking fluently, she'll be fine. She also pointed out, though, that kids with speech problems usually develop reading problems when they get to elementary school...so we should be prepared for that.

Feeding Update-
After traveling across town on Saturday for the Y-cut nipples, Lydia was still not able to get the formula with oatmeal out of the nipple. After many trials, we've found this combination: formula (without added calories) and 1/8 teaspoon of oatmeal per ounce (which adds calories too) with the #3 faster flow nipple. I can't figure out why she can get it out of the #3 nipple and not the y-cut since the hole is clearly bigger, but nothing with Lydia has really been predictable. I will probably soon try to add more calories to the formula again, but it was just too thick for her that way...and she was still having reflux. The oatmeal has helped to decrease the reflux (for now, anyway).